12/9 Tawny Pre-Visit Update in 12/8 Condo

[DD & Tinkerbell]

This morning Dr. Amanda says that Tawny is still taking those baby steps in the right direction and looks a little better again this morning, but is still very weak and being watched very carefully.

She is back to getting her 2.5u of Lantus BID as of today.

She did not go over all the oral meds w/me but one Tawny is getting is Reglan, Dr. Amanda said there are anti-nausea properties in that & also that b/c of the etube she felt it was a better choice right now than the ondansetron b/c Reglan also has some properties that helps (and here I go again with my lame layman's interpretation of this) 'move the food thru the digestive tract.'

Tawny is able to free feed and is eating a tiny bit of dry food on her own. They are monitoring her intake carefully and when/if she does not eat enough the are feeding her via the e-tube. One of the techs opened a bag of beef jerky by Tawny's kennel this a.m. and Dr. Amanda said when the tech did that Tawny's head popped up like she was real interested in some of that! But Dr. Amanda told her no, she couldn't have any beef jerky!

She said she would check her urine with a ketostick this p.m. and call me with the ketone #s, they were still going down yesterday p.m.

I can visit her in the morning!

YAY! I'm gonna scritch her and hug and love her for all of us!

Desi

 

[Dyana]

Re: 12/8 Tawny AM Update

I'm so glad you get to visit her tomorrow. Take something like an unwashed pillow case or sweatshirt for her. Something from home :razz:
Why do they check ketones via urine, instead of blood?

Have a good day, Desi.

 

[Linda for Weezer]

Re: 12/8 Tawny AM Update

More baby step good news! Keep getting better Tawny.

I'm glad you get to be with her today. We're all praying for a complete recovery and a strong, happy girl.

 

[CD and BigMac]

Re: 12/8 Tawny AM Update

Tawny is surrounded by LOVE!

 

[mybuddybinks]

Re: 12/8 Tawny AM Update

will grab ma bags and come hep u carriez alla t'ings home...
and i will rock da ham-muck gentle while u sleepz
Binks

 

[Lisa and Do Lou (GA)]

Re: 12/8 Tawny AM Update

from Lisa and Do Lou


wonderful Tawny report sending lots of prayers for her continued recovery

 

[Karrie and Maverick]

Re: 12/8 Tawny AM Update

Your vet doesn't know that reglan does NOT work for cats for nausea. It does for dogs but not for cats. You are spending money on things that aren't going to help very much. I will PM you the link to the nausea file on FAF which explains why it doesn't work for cats. I'm sorry to sound like I'm beating you up about this. I knew your vet would probably pull that. It may help some but I don't feel it is best for Tawny. Maverick was on both Reglan and Ondansetron. But Maverick had the PEG tube which went through the stomach wall and had major abdominal surgery where they opened his stomach. There is a chance that the stomach stops moving food through which happened in his case. He needed the reglan to help stomach motility.

While I am here, a few more important things.
Do not hyperfocus on getting her to eat on her own. She still feels like crap. Use the tube, its there. If Tawny were my cat I would exclusively tube feed for a week before even presenting her with food. I would feed a high calorie low carb food like Royal Canin Recovery RS or Wellness Chicken. Blended like heck AND STRAINED with enough water to make it go through the tube. Or Clinicare like violet and Garland did because it has 1 calorie per ml.

Feeding
-make it pleasurable.
-1cc at a time and break for thirty seconds or longer
-if she bolts during feeding drop the syringe. You can't hold her back by holding onto the syringe and you could pull the tube out. You'd rather clean up a mess.
-no need to do a preflush of the tube - it just fills up space in the tummy with water. Do a post flush only of 6-8 mls. Maverick's PEG tube was wider and 13" long and six mls cleared his tube. The post flush will keep the tube clear of debris and avoid clogging.
-have coca cola on hand in case of clogs. Don't let your husband drink it or throw it out. Plain pure coca cola, not pepsi or diet.

Here is a link to the FAF nausea article.... it only works for FAF members though. I wish I could share it with everyone. If I didn't feel it was important Desi, I wouldn't keep going on about it.

[url=http://tinyurl.com/nausea-file]http://tinyurl.com/nausea-file[/url]

You have the tube. Use it. Don't race her back to eating on her own. Focus on getting the maximum calories in. Most cats can't handle more than 40ccs (average is around 30-35) of volume every 3 hours. The stomach should be empty around 2.5 hours. Chart her feedings on your spreasheet. Watch for signs of nausea when feeding so you know when to stop to avoid her throwing up everything fed. Teeth grinding, lip licking/smacking, stomach lurching...

 

[DD & Tinkerbell]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Dr. Amanda just called, and said when she checked Tawny's urine late this afternoon there were NO KETONES!

THE KETONES ARE GONE! THE KETONES ARE GONE! YAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAY!!!!!!!!!!!!!!!!!!! I hooted YAY! so loud on the phone I probably busted one of doc's eardrums!

And she said Tawny continues to do better, that they even had her out walking around a little in the medicine room w/them. She is very weak tho. Well of course she's weak, I know I would be if I'd gone thru all she's gone thru. Again. Poor baby.

I am going to go see Tawny in the morning. I am taking print outs of a lot of the data you all have sent or sent links to, including the one about the Reglan Karrie mentions above. And also the abstract on the blood vs. urine ketones posted the other day, and the info on the TR Protocol. There's such a delicate balance when sharing info with vets around here, they always seem to be so put off by it, like you are questioning their ability or s/thg, but I am taking it all to give them anyway. I can't make them read it, but I can take it to them. These vets at LVRC tend to be a little more receptive anyway than these ones here in Mayberry (altho I must say the one I have been working w/for a few years now has gotten a lot better), like when I told Dr. Hebert @ LVRC the 1st time Tawny was there "no convenia", instead of giving me a lecture about not being a vet and not knowing what I was talking about she wanted to know why. (That reminds me, I gotta print that info out too!).

Your vet doesn't know that reglan does NOT work for cats for nausea. It does for dogs but not for cats. You are spending money on things that aren't going to help very much. I will PM you the link to the nausea file on FAF which explains why it doesn't work for cats. I'm sorry to sound like I'm beating you up about this...

Karrie, I do not feel like you are "beating me up" about any of this in any way, shape or form! I do not feel like anybody is, at all. I am so very very grateful for every single bit of info, every tip, every insight, every "I've been there, done that" story, every link you and everyone else is sending. I do not feel "beat up" at all.

I have printed out so much data from what so many of you have sent that I have practically wallpapered the whole wall behind the table where I do all the home "vetting" with it, that way it'll always be right there for me to refer back to.

I am for sure on information overload but that's a good thing!

And Karrie, you have no idea how valuable tips like the following are to me:

-if she bolts during feeding drop the syringe. You can't hold her back by holding onto the syringe and you could pull the tube out. You'd rather clean up a mess.

and

-have coca cola on hand in case of clogs. Don't let your husband drink it or throw it out. Plain pure coca cola, not pepsi or diet.

I for sure would have tried to hold onto her if she bolted during feeding, my instinct would have been to not drop the syringe! And I'm a Dr. Pepper drinker, I cannot stand Coke, so I would not have had any on hand. I just pulled 3 bottles off the shelf at the store to go home w/me today! I live alone w/my critters so I think the Coke will be safe from other predators!

I do also plan on using only the tube only for as long as need be once I get her home. Somehow that free feeding and tube feeding just doesn't compute w/me, so I am glad you pointed that out, too.

Thank you everyone for the cards and the hugs and heart pix today. Binksie, you best be ready cuz Dr. Amanda said it is her goal to send Tawny home this weekend, but that we still had to wait and see. I laughed out loud so hard when I saw that Hug Attack pic today Celi that everyone in the kitchen in the diner at the store thought I'd gone completely off my rocker! (Well, actually they already thought that, they just thought it was extra special today. They have no idea; it was!)

And of course CD when I saw the pic of Tawny covered with hearts all I could do is say "AWWWWWWWWWWWWWWWWWWWWWWWW" and wipe the tears away.

Lisa and Do Lou, Tawny loves the rose and when I saw that card I could actually smell the rose! Something I needed desperately right now, to stop for a minute and
smell the roses.

I am printing out all the cards & pix and putting them on the "home vetting" info wall too!

Dyana, I am going to talk to them about the blood ketone vs. urine ketone thing in the morning, I just don't know why at this point. Sharyn and Fiona and Sienne and others have posted a lot of valuable info about this, including the abstract mentioned above, and I am taking print outs of it all with me tomorrow as well.

Thank you everyone for posting, for praying, for caring. Altho I don't post much in others condos right now, I read so many of them and see your thoughts and prayers and love going out to me and Tawny every day. I am touched beyond words. And me being wordless is a rare thing.

I really really love you guys.

Desi

 

[Dyana]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Ketones Are Gone!
I'm screaming as loud as you are YAY!!!!!!!!!!!!!!!!!!!!!!!!!

 

[DD & Tinkerbell]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Ketones Are Gone!
I'm screaming as loud as you are YAY!!!!!!!!!!!!!!!!!!!!!!!!!

I can hear you!!!!!!!!!!!!!!!!!!!!!!

 

[Dyana]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

I'm just so happy. Your update, just made my day (evening) I hope you get a good rest tonight. You may need it.

 

[Anne & Zener GA]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Keep on keeping on Tawny! dancing_cat

 

[Ella & Rusty & Stu(GA)]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Desi, this is such good news! Rusty and I are dancing!! dancing_cat dancing_cat

Lots and lots of :YMHUG: :YMHUG: :YMHUG: :YMHUG: to Tawny and you!

Ella & Rusty

 

[Karrie and Maverick]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Thank you for loving Tawny and doing everything you can.

Some people on here have a gift with words. I seem to write like a robot with bad grammar LOL. Glad your coca cola was safe. Every time I needed it my husband had drank it or tossed it. It was a bad first week for Maverick and I with clogs until someone recommended straining the food in a fine metal seive. I can give more tips about saving time making the food up in advance etc. you only use a few mls of coke to unclog the tube but its worth its weight in gold if you need it.

Sending lots more hugs.

 

[mybuddybinks]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

THIS IS WONDERFUL!!

And WOW! on the onfo...
this is the most caring, giving place we have ever known.

 

[Violet and Garland]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Good luck! Yay on the ketones!!!

Blood ketones are much more accurate than urine. Garland is a ketone prone cat, so a urine test may be negative, then the next day she's sick bc her blood would have shown me a true number.

I used recovery blended in a blender with Clinicare for Garland. I would do 3 cans at a time and keep it in the fridge ready to go. I used my sons baby bottle warmer to heat her serving She took 36cc every 3-4 hours. You have to go really slow at first . 1cc, pause. 1cc, pause

I liked the little 12cc syringes bc I could push it easier than the huge massive ones. (they hurt my hand) but you will find what works for you best.

Coca cola unclogged Garlands tube. We were lucky it only happened once. Totally freaked me out too, bc I had no idea how to fix it. I'm sooooo grateful Karrie was with me to hold my hand. She is so amazing!

Thinking of you guys!!

 

[Venita]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

On Tawny's progress, I also say :RAHCAT :RAHCAT :RAHCAT

I also got a call from Dr. Amanda yesterday evening.

She will be adding Ondansetron to Tawny's take home meds. She thought she might have some in the "donated meds" locker to start Tawny on right away. Desi, do ask for a written script for Ondansetron when you see Tawny this morning and shop around for a good price.

LVRC is being very good about working with the suggestions we bring up and working within our relatively slim (for ER care) budget. When Dr. A called me yesterday, the bill (before the rescue discount) was $1900. The chip-in for this 3rd hospitalization for Tawny is showing $333 in donations.

Dr. Amanda lets me know about the concessions the clinics makes. When Tawny's E-tube was put in, the LVRC only charged DCIN for the materials--and at cost--not the skill to do the insertion or any "profit."

Urine ketones is this clinic's way of testing Tawny for ketones. It might be a "rut" they are in, or it might be their way of keeping costs down. Desi, I am hesitant to suggest that you take Tawny's blood ketone meter and strips there for them to keep to use on her, because I believe you told me her blood glucose meter got "lost" there (which happens). But you might want to take the blood ketone meter along in the morning and do your own test. Then bring it back home. Perhaps DCIN can donate a blood ketone meter and some strips to the clinic to help change its approach to this diagnostic.

Even though I suggested to Dr. Amanda on Wednesday night that the clinic blend Tawny's tube food with Clinicare instead of water (to add nutritional value), I think that suggestion rolled off her back at the end of a very long day. (Dr. A is working 12+ hours/day.)

Desi, I have been told by a DCIN friend who has been through multiple DKAs and feeding tubes with her multiple special-needs cats that she only feeds Clinicare through the feeding tube. Complete, quality nutrition without the clogs of blenderized wet food. Please pick some up today in advance of Tawny coming home. Have it put on DCIN's bill. DCIN can get Clinicare on Amazon for Tawny for $5/can (plus $5.65 for shipping for multiple cans), so please consider the relative cost when you choose how many to bring home. If the clinic is charging $15/can, you may only need one or two until DCIN can get some to you from Amazon.

 

[Karrie and Maverick]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

I wouldn't do just clinicare. Its 25% carbs and high in sugar.

I would do the Recovery RS or even Wellness Chicken or Turkey blended with Clinicare just to thin it. With the feeding tube and overnight feedings you will be able to get enough food into her if she keeps the food down. If she doesn't just clinicare may be an option.

Maverick was getting a 5.5oz can plus another 1/2 of a 5.5 oz can per 24 hours to maintain his weight. Initially I had to do overnight feedings to maintain his weight. With DKA you need to feed 2.5x's the normal amount of food. I am not sure when its safe to cut back on feeding/calories though. Sandra and Black kitty was advising on this with Garland and Violet.

The thing with the food is you need to strain it or it will clog the tube. It's a fine metal mesh strainer - not one with bigger openings. Here are the instructions for preparing the food:

1. Blend and blend and blend some more with an electric blender.
2. Add enough warm water so that it is a thick milkshake consistency. Not watery. Blend.
3. I had a tupperware that I could put in the fridge for a days worth. Some people do a couple days worth at a time. I poured some of the blended food into the strainer and tapped it on the rim of the tupperware to help the food go through. Scrape the food off the bottom of the strainer and rinse it off to get rid of the gritty bits that are in the bottom. Rinse the strainer and repeat until the food is all strained.
4. Suck up the food into the syringes. Store them upright for a few minutes with a bit of extra space at the top. Store them upright in a cup or container so that the air bubbles go to the top. You can tap the syringe upright to get stubborn pockets of air if there are any to the top. Squeeze out the air. Air in the food can cause stomach gas but a small amount won't be an issue.
5. You can prefill the syringes to save time. You can warm them up by soaking them in water ten minutes before a feeding.

Regarding the syringes... get lots of them from the vet. The rubber wears out and sticks. I still have food on the ceiling in my kitchen. Pippens roost sells noring syringes which are highly recommended for tube feeding.

What kind of tube end does she have - I assume its one with just a cap and not a luer lock. When feeding pinch the tube near the end before adding and removing syringes to keep air out of the tube.

And remember... DO NOT DO A PREFLUSH. It just puts water in the tummy where food and calories can be. The postflush is important to keep the tube free from food. You will do a post flush of water (not clinicare) after meds also. Six mls should be enough.

Throwing a lot at you. But once you start doing this, it will become routine.

 

[Angela & Blackie & 3 Others]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

That's extremely wonderful news, Desi!!! :RAHCAT :RAHCAT :RAHCAT Still sending tons of healing vines, and positive thoughts and wishing for her to continue to make a full and speedy recovery. WOO HOOO!!!!!!!!!!!!!!!!!!!!

 

[DD & Tinkerbell]

Re: 12/8 Tawny PM Update - KETONES ARE GONE!

Urine ketones is this clinic's way of testing Tawny for ketones. It might be a "rut" they are in, or it might be their way of keeping costs down. Desi, I am hesitant to suggest that you take Tawny's blood ketone meter and strips there for them to keep to use on her, because I believe you told me her blood glucose meter got "lost" there (which happens). But you might want to take the blood ketone meter along in the morning and do your own test. Then bring it back home. Perhaps DCIN can donate a blood ketone meter and some strips to the clinic to help change its approach to this diagnostic.

I am going to leave to go visit Tawny in about an hour, as soon as I give Tinkerbell her shot.

I have printed out some data, not too much to overwhelm anybody at the clinic I hope, including the info & abstract and blood ketones vs. urine ketones. I am taking my blood ketone meter along to get my own test on Tawny and hopefully share this with the vet(s) along w/the printed data. I fully intend to bring my meter back home w/me, as Venita points out, that's very important! DCIN's offer of donating one w/some strips is very generous, I hope the clinic is receptive of that idea (which I leave the suggestion and details of to your good graces, Venita!)...

Desi, I have been told by a DCIN friend who has been through multiple DKAs and feeding tubes with her multiple special-needs cats that she only feeds Clinicare through the feeding tube. Complete, quality nutrition without the clogs of blenderized wet food. Please pick some up today in advance of Tawny coming home. Have it put on DCIN's bill. DCIN can get Clinicare on Amazon for Tawny for $5/can (plus $5.65 for shipping for multiple cans), so please consider the relative cost when you choose how many to bring home. If the clinic is charging $15/can, you may only need one or two until DCIN can get some to you from Amazon.

I will get a couple cans of clinicare today and also for an ondansetron scrip when I am there this morning.

Also I am taking my tape measure so I can get Tawny's neck measurement so I can order 2 Kitty Kollars today (1 to wear, 1 to wash).

Karrie, your food prep instructions are on "the wall" now too...that wall is really getting full. I have started using highlighters on key points so it's getting colorful now too!

And of course I am taking my camera.

Everyone please keep the suggestions coming b/c I am gonna need all the help I can get. And then some!

Desi

 

[Ella & Rusty & Stu(GA)]

Thinking of you and Tawny this morning, Desi, as you head to the clinic. I hope you find your girl much improved.

Rusty sends love,

Ella & Rusty

p.s. I'm amazed at how much good info. you're getting!! I'm printing out some of it in case I might need it in the future!

 

[Jean and Megan]

We all know how high vet bills can get, before you have time to turn around. Let's get the chip-in total for Tawny up a bit! Even small donations will help. I know the economy is bad, but if you can find even $5, that's better than nothing.

 

[Violet and Garland]

Ask for A TON of syringes while you are there. All different sizes and multiple ones of the same size. They wear out fast and start sticking

Good luck!!